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Mindie H. Nguyen - One of the best experts on this subject based on the ideXlab platform.
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Improved Performance of Serum Alpha-Fetoprotein for Hepatocellular Carcinoma Diagnosis in HCV Cirrhosis with Normal Alanine Transaminase.
Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2017Co-Authors: Ju Dong Yang, Mindie H. Nguyen, Jianliang Dai, Amit G. Singal, Purva Gopal, Benyam D. Addissie, Alex S. Befeler, K. Rajender Reddy, Myron Schwartz, Denise M. HarnoisAbstract:Background: The utility of alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC) surveillance is controversial. We aimed to identify factors associated with elevated AFP and define the patients for whom AFP is effective for surveillance.Methods: Data from the NCI Early Detection Research Network phase II HCC biomarker study (233 early-stage HCC and 412 cirrhotic patients) were analyzed. We analyzed 110 early-stage HCC and 362 cirrhotic hepatitis C virus (HCV) patients for external validation. Sensitivity, specificity, and area under the ROC curve (AUC) for HCC were calculated.Results: HCV etiology, non-White race, and serum Alanine Transaminase (ALT) predicted elevated AFP in cirrhotics. Non-White race and ALT predicted elevated AFP in HCC patients. Higher AUC of AFP for HCC was noted in patients with HBV (0.85) and alcohol (0.84), whereas it was lower in patients with hepatitis C virus (HCV; 0.80) and nonviral/alcohol etiology (0.76). The AUC was higher in HCV patients with serum ALT ≤40 U/L than patients with serum ALT >40 U/L (0.91 vs. 0.75, P 40 U/L (0.79 vs. 0.69, P = 0.10) in the validation cohort.Conclusions: The satisfactory performance of AFP in HCV patients with normal ALT should be further validated.Impact: The AFP may serve as a valuable surveillance test in HCV patients with normal ALT. Cancer Epidemiol Biomarkers Prev; 26(7); 1085-92. ©2017 AACR.
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systematic review with meta analysis the proportion of chronic hepatitis b patients with normal Alanine Transaminase 40 iu l and significant hepatic fibrosis
Alimentary Pharmacology & Therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
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Systematic review with meta‐analysis: the proportion of chronic hepatitis B patients with normal Alanine Transaminase ≤40 IU/L and significant hepatic fibrosis
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
D. T. Chao - One of the best experts on this subject based on the ideXlab platform.
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systematic review with meta analysis the proportion of chronic hepatitis b patients with normal Alanine Transaminase 40 iu l and significant hepatic fibrosis
Alimentary Pharmacology & Therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
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Systematic review with meta‐analysis: the proportion of chronic hepatitis B patients with normal Alanine Transaminase ≤40 IU/L and significant hepatic fibrosis
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
Walid Ayoub - One of the best experts on this subject based on the ideXlab platform.
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systematic review with meta analysis the proportion of chronic hepatitis b patients with normal Alanine Transaminase 40 iu l and significant hepatic fibrosis
Alimentary Pharmacology & Therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
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Systematic review with meta‐analysis: the proportion of chronic hepatitis B patients with normal Alanine Transaminase ≤40 IU/L and significant hepatic fibrosis
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
Joseph K. Lim - One of the best experts on this subject based on the ideXlab platform.
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systematic review with meta analysis the proportion of chronic hepatitis b patients with normal Alanine Transaminase 40 iu l and significant hepatic fibrosis
Alimentary Pharmacology & Therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
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Systematic review with meta‐analysis: the proportion of chronic hepatitis B patients with normal Alanine Transaminase ≤40 IU/L and significant hepatic fibrosis
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
Long H. Nguyen - One of the best experts on this subject based on the ideXlab platform.
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systematic review with meta analysis the proportion of chronic hepatitis b patients with normal Alanine Transaminase 40 iu l and significant hepatic fibrosis
Alimentary Pharmacology & Therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.
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Systematic review with meta‐analysis: the proportion of chronic hepatitis B patients with normal Alanine Transaminase ≤40 IU/L and significant hepatic fibrosis
Alimentary pharmacology & therapeutics, 2014Co-Authors: D. T. Chao, Joseph K. Lim, Walid Ayoub, Long H. Nguyen, Mindie H. NguyenAbstract:Summary Background Chronic hepatitis B (CHB) may lead to cirrhosis, hepatocellular carcinoma and premature death. Elevated Alanine Transaminase (ALT) levels ≥ the upper limit of normal (ULN) are a major determinant for initiating anti-viral therapy; however, ALT levels alone may not be predictive of hepatic fibrosis. Aim To determine the proportion of CHB patients with ALT ≤40 IU/L and liver fibrosis stage ≥2. Secondary goals include subgroup analysis by hepatitis B e antigen (HBeAg) status, high hepatitis B virus (HBV) DNA levels, Asian ethnicity, lower ULN of ≤30 IU/L (males) and 19 IU/L (females), and advanced age. Methods Studies identified in EMBASE and MEDLINE (1/1990–6/2012) using the search criteria: “Hepatitis B”[Mesh] OR “Hepatitis B virus”[Mesh] OR “Hepatitis B, Chronic”[Mesh])) AND “Alanine Transaminase”[Mesh]) and abstracts containing the term ‘hepatitis’ from recent major U.S. gastroenterology and liver society meetings were considered. Results Among nine studies (N = 830 patients), a significant proportion (20.7%; 95% CI: 16.2–26.0%) of CHB patients with ALT levels ≤40 IU/L had significant fibrosis irrespective of HBeAg status, high HBV DNA levels, ethnicity or age, although this proportion may be higher in patients older than 30–40 years old. The corresponding proportion was 27.8% even when the newer ULN of 30 IU/L (males) and 19 IU/L (females) was applied. Conclusions Approximately one fifth of CHB patients with ALT ≤40 IU/L may have significant hepatic fibrosis. The approach to such patients should be individualised, as further evaluation and treatment may be appropriate.